or young adults while the CD group is evenly spread throughout the age groups. This resulted in a difference of 24 years in the median age (16 years versus 40 years) at transplantation (p = 0.000). There was also differences amongst racial groups with black patients being twice as common in the CD as compared to the CHF group (p = 0.013). There was a statistically significant difference in patient (p = 0.020) and graft survival (p = 0.003) between patients with CHF versus CD. A total of 305 kidney transplants were performed in 235 individuals with either CHF or CD;172 received 1 graft, 56 received 2 grafts and 7 received 3 grafts. Patient survival was better with simultaneous (p= 0.020) and kidney transplant after liver transplant ( p = 0.034), Figure 1. Liver graft survival was significantly better with simultan- eous liver and kidney transplant (p = 0.015). Multivariate analysis confirmed age, race, CHF versus CD and simultaneous kidney transplantation as significant for graft survival; The same factors were also significant for patient survival apart from simultaneous kidney transplantion. Conclusion: Patients with CHF and CD, although related etiologies, have diverse outcomes for liver transplantation. Patients with CD undergo liver transplantation across wider ages than CHF patients. CD patients have worse graft survival and higher rates of death than CHF patients. Both groups of patients benefit from kidney transplantation either simultaneously or following liver transplantation. THU259 Outcomes of liver transplantation for metabolic disorders in children Khalid Khan 1 , Ahmed Elsabbagh 2 , Stuart S. Kaufman 1 , Nada Yazigi 1 . 1 MedStar Georgetown University Hospital, Transplant Institute, Washington, United States; 2 St Vincent’s Hospital, Surgery, Indianapolis, United States Email: khalid.m.khan@gunet.georgetown.edu Background and Aims: The main indication for liver transplantation (LT) in children has been biliaryatresia. Recent advances in surgical management and the development of new immunosuppressants have made LT a viable therapeutic option for an increasing number of disorders in this modern era. In particular LT has become an effective therapeutic modality for patients with metabolic liver diseases, especially urea cycle disorders. To be considered a treatment of choice for metabolic patients, LT must have at least equivalent outcomesto biliaryatresia. As a large center for LT for metabolic disorders we are able to examine this issue. Method: This was a retrospective analysis comparing between isolated pediatric liver transplantation for metabolic liver diseases (N = 62) versus biliary atresia (N = 55) in the period between January 2008 and December 2018. Standard statistical software was used. Proportions are compared using chi-square and continuous variable using student t-test. Kaplan-Meyer curves are constructed and compared using the log-rank test. Results: The median age for the metabolic group was 2 (0.16–16) year versus 1 (0.4–15) year for the biliary atresia group (P = 0.0001). 41.9% were female in metabolic group versus 73.6% in biliaryatresia group (P = 0.001). 14.5% were African American in the metabolic group versus 41.5% in biliary atresia group (P=0.010). Graft types included whole liver, cadaveric split liver, living donor segmental liver (54.8%, 38.7%, 6.5% in the metabolic group versus 40%, 27.3%, 32.7% in the biliary atresia group, P = 0.001). The 1-, 3-, and 5-year patient survival for the metabolic group were identical to the biliary atresia group (95%, 95%, and 95%). The 1-, 3-, and 5-year graft survival for metabolic group was 92%, 92%, and 92% versus 87%, 87%, and 87% for the biliary atresia group (P = 0.418). Postoperative complications included biliary (14.5% in metabolic vs. 33.3% in the biliary atresia group, P = 0.017), vascular (19.4% in the metabolic group vs. 35.8% in the biliary atresia group, P = 0.047), postoperative bleeding (16.1% in metabolic group vs. 20.8% in the biliary atresia group, P = 0.522). High grade Clavien-Dindo (3B or higher) compli- cations were significantly less in the metabolic group (25.8% vs. 48.1% in the biliary atresia group, P = 0.014). Acute rejection tended to be higher in metabolic group (37.1% versus 21.8% in the biliary atresia group, P = 0.072). Conclusion: Pediatric liver transplantation for metabolic liver diseases in our high volume center has excellent outcomes in comparison to biliary atresia. It has similar patient and graft survival but with less postoperative complications and readmissions. Rejections tended to be higher in metabolic group. THU260 Assessment of long-term risk of cardiovascular disease after liver transplantation Kirsty Miles 1 , Usman Ahmad 1 , Alexandra Hinkson 1 , Lisa Bridgeman 1 , Richard Parker 1 . 1 Leeds Teaching Hospitals NHS Trust, Leeds Liver Unit, Leeds, United Kingdom Email: kirsty.miles1@nhs.net Background and Aims: The risk of cardiovascular disease (CVD) is increased in people who have undergone liver transplant (LT) and is a common cause of death in long-term follow-up studies. Risk assessment for CVD is commonplace in non-transplant cohorts but the relevance of commonly used systems of CVD risk scores in the UK have not been evaluated in liver transplant patients. This is important as accurate risk assessment can guide interventions to reduce cardiovascular risk such as statin therapy. We evaluated the accuracy of Q-RISK, Framingham-CVD and the BNF scores in a cohort of patients in Leeds. Method: All patients who had undergone a first liver-only trans- plantation in Leeds from 2008–2012 were identified from a prospectively maintained database. Those patients over 25 and surviving for at least 1 year after LT were included. Baseline characteristics were noted and information about clinical outcomes was extracted from clinical notes. CVD that occurred after the first year of follow-up were noted to exclude peri-operative events. Ten- year risk scores for CVD were calculated at 12 months after LT. Test accuracy was assessed with receiver-operator curves using the “pROC” package in R. Results: In total (367–36 deaths – 16 under 25) 315 patients were included with a maximum of 10.6 years follow-up (median 7.2 years, IQR 5.5–8.4 years). After the first year of follow-up, there were 27 patients with incident CVD (8%) – of which one event (a myocardial infarction) was fatal – giving a crude event rate of 1.1%/year. At twelve months after LT, median CVD risk scores were: Q-RISK 2 8.8 (IQR 3.5– 14.4), Framingham CHD 3.4 (1.2–7.3) and BNF 2.8 (1.0–6.1). The Q- RISK score had the best performance: AUROC 0.72 (95%CI 0.62–0.82) followed by the Framingham CHD score, AUROC 0.70 (95% CI 0.61– 0.79) and the BNF score, AUROC 0.69(95% CI 0.60–0.78). POSTER PRESENTATIONS S268 Journal of Hepatology 2020 vol. 73 | S123–S400